Individual
JACQUELINE MELLYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1935 N STAPLEY DR, MESA, AZ 85203-2749
(480) 610-4173
Mailing address
1935 N STAPLEY DR, MESA, AZ 85203-2749
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S007339
AZ
Other
Enumeration date
07/19/2010
Last updated
07/19/2010
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